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PEORIA, Ariz.  Casey Kelly is awaiting a second opinion before making a final decision on elbow reconstruction surgery.

But the 23-year-old starting pitcher Thursday said there appears to be few good options other than “Tommy John” surgery.

“I’ve prepared myself for the worst,” said Kelly at an impromptu press conference in a hallway of the Padres spring training complex.

“I don’t have too many options. The doctors are concerned with what they saw.”

Kelly, who last appeared in a spring training game on March 7, had his elbow examined by Padres’ team physician Dr. Heinz Hoenecke in San Diego Tuesday.

Kelly said the exam showed “micro tears” in the ulnar collateral ligament in his right elbow. Tears in the UCL are treated by either prolonged rehab sessions or “Tommy John” surgery – which replaces the ligament with a ligament taken from either the opposing forearm or a leg. Rehab following elbow reconstruction surgery can tak from 12 to 18 months.

Kelly had similar elbow problems last year. And the problems have reappeared after each of two lengthy rehab sessions.

“This is not black and white,” said Kelly. “If nothing had happened last year, we might not be talking about surgery now. I definitely don’t want to jump into surgery, but rehab hasn’t worked.”

Kelly first experienced elbow problems while with Triple-A Tucson last April and spent 3 ½ months on the disabled list due to what was called a “right elbow strain.”

After a rehab assignment with Double-A San Antonio, Kelly joined the Padres on Aug. 27 and was 2-3 with a 6.21 earned run average in six starts with the Padres. But the pain in his elbow returned toward the end of the season and he was shut down before his final scheduled start. He spent the winter rehabbing the elbow a second time.

“The MRI Tuesday was not much different from last year,” said Kelly. “Surgery was an option last year, but the option was to rehab the elbow. They didn’t see enough last year for surgery.

“What to do is different for each person. These are uncharted waters for me. But rehabbing the elbow twice hasn’t gotten it better.”

Kelly said surgery is “still up in the air” until he gets a second opinion, likely from famed orthopedic surgeon Dr. Lewis Yocum of Los Angeles.

Kelly said the pain in his elbow returned after his March 7 outing against the Angels.

“I felt something that game,” he said. “The next day it didn’t recover. I want to make sure before I go ahead in any direction.”

Kelly seemed to support manager Bud Black’s opinion that the damage to his elbow was cumulative and not the result of any one pitch.

If Kelly goes ahead with the surgery, he will be the fourth Padres pitcher in a span of 10 months to have “Tommy John” surgery. Developing staff ace Cory Luebke had the procedure last May and hopes to return to the rotation around the All-Star break. Joe Wieland and minor league prospect Juan Pablo Oramas also had elbow reconstruction surgery last season.

Kelly is regarded as one of the top three prospects in the Padres organization. Another top three prospect, right fielder Rymer Liriano, was lost for 2013 when he had “Tommy John” surgery three weeks ago.